SB: 'The Only Place to Go in Crisis Was the Worst Place to Go'

Program fills void that patients in crisis face

By Cynthia H. Craft  Sacramento Bee  August 31, 2012

When Leslie Napper finds herself in a mental health crisis, the only place to go now is the worst place to go - the nearest hospital emergency department.

There, doctors ill-equipped to treat mental health crises attend to trauma injuries while Napper and others like her lie on gurneys in hallways for days at a time.

"There's no choice but to wait it out. One could easily go into a full-blown crisis in the ED," says Napper, who's been haunted by hallucinations - what she calls her "shadow people" - since she was a teen.

So Napper decided something needed to be done about Sacramento County's dearth of healthy destinations for the mentally ill or even their stressed relatives.

She joined with peers, community mental health experts, the county's Division of Behavioral Health Services and the Sierra Health Foundation to help shape the Respite Partnership Collaborative.

The Sierra Health Foundation officially launched the collaborative on Thursday with the ultimate aim of providing respite to residents needing a safe place to go while in a crisis.

Respite programs will go a long way toward patching the safety net left tattered by Sacramento County's budget cuts in 2010, said Robert Phillips, director of health programs for the Sierra Health Foundation.

The cutbacks effectively left those in mental health crises with few alternatives to emergency department visits or psychiatric hospitalization.

Financing for the respite centers will come from Sacramento County's Proposition 63 funds. The 2004 initiative, known as the Mental Health Services Act, specifically sets aside a portion of funds for the development of innovative solutions to serving the needs of mental health consumers.

Already, $1.3 million has been committed to the first of a four-year funding commitment for the Respite Partnership Collaborative.

Requests for proposals for programs were opened up to the 22 members of the collaborative and others on Thursday, and respite centers are expected to be established within the year.

The centers may take many forms, but Napper said she personally envisions home-like settings in various communities throughout the county that would be open for drop-in visits 24 hours a day, seven days a week.

There, a consumer in crisis would be able to access "a safe place to go, a quiet place to be," Napper said, where peer services, coping counseling and medication adjustments might be available from staff on hand. Temporary housing is crucial as well, Napper said, as it can take four days to recover from a break.

Especially with the dreary economy weighing heavily on people's minds, a respite center can be a lifesaver in helping many clients stay well.

"Since the fiscal downturn, there seems to be a higher need," said Phillips, citing figures predicting one in four Americans stands a chance of suffering a diagnosable mental disorder.

But the respite centers will not be limited to people with diagnosed conditions. Family members strained by caregiving will be welcome - including those tending to parents with Alzheimer's disease - in addition to parents of severely emotionally disturbed children, stressed teens and members of cultural or ethnic populations.

One of the things that's innovative about the program is that it will be the first in California to be run by a collaborative of various interests instead of the county.

"It's amazing," said Napper. "It's a rainbow of people interested in consumer health. It's really nice to speak to each other, share solutions and bounce ideas off each other."